TABLE 2.
Clinical manifestations and potential immunological effects of micronutrient deficienciesa
| Micronutrient | Deficiency symptom(s) | Potential effect(s) on immune function | Reference(s) |
|---|---|---|---|
| Iron | Hypochromic anemia, cognitive deficits, behavioral abnormalities | See the text | |
| Zinc | Anorexia, reduced growth, skin lesions, impaired wound healing, frequent infections | See the text | |
| Iodine | Goiter, impaired cognitive development | Granulocyte function, myeloperoxidase activity | 539 |
| Copper | Sideroblastic anemia, reduced growth, osteoporosis | No. of phagocytes, phagocyte activation, T cell activation | 540 |
| Selenium | Cardiomyopathy | See the text | |
| Vitamin A | Xerophthalmia (night blindness, xerosis), keratomalacia (blindness); increased susceptibility to and severity of infections | See the text | |
| Vitamin C | Scurvy (diarrhea, gingivitis, arthropathy), skin changes (petechiae, perifollicular hemorrhage, and bruising) | See the text | |
| Vitamin D | Rickets, osteomalacia | See the text | |
| Vitamin E | Neuropathy, ataxia, retinal degeneration, hemolytic anemia (almost never observed from simple dietary deficiency) | Epithelial barrier, T cell activation, NK cell activity | 541, 542 |
| Vitamin K | Bleeding diathesis (almost never observed from simple dietary deficiency) | T cell proliferation, regulation of inflammation (NF-κB) | 543 |
| Thiamine (vitamin B1) | Beriberi (peripheral neuropathy, cardiomyopathy, seizures; in infants, laryngeal paralysis with aphonic cry), Wernicke-Korsakoff syndrome | Unknown | |
| Riboflavin (vitamin B2) | Angular stomatitis, glossitis, cheilitis, seborrheic dermatitis | Phagocyte activation | 544 |
| Niacin (vitamin B3) | Pellagra (diarrhea, photosensitive dermatitis, dementia) | Unknown | |
| Pantothenic acid (vitamin B5) | Paresthesias and dysesthesias (“burning-feet syndrome”) | Unknown | |
| Pyridoxine (vitamin B6) | Dermatitis, angular stomatitis, glossitis, neuropathy | Antibody production, T cell activity and phenotype, DTH response, NK cell activity | 541 |
| Biotin (vitamin B7) | Hypotonia, exfoliative dermatitis | Regulation of inflammation, DC function, and NK cell and CTL activity | 545, 546 |
| Folate (vitamin B9) | Megaloblastic anemia, neural tube defects, cleft lip | No. of lymphoid and myeloid cells, T cell activation, NK cell activity | 103, 112 |
| Cobalamin (vitamin B12) | Megaloblastic anemia, ataxia, muscle weakness, spasticity, incontinence, dementia | Antibody production, no. and activity of T cells, NK cell activity | 541, 547, 548 |
a
DTH, delayed-type hypersensitivity; CTL, cytotoxic T lymphocyte.